There are many examples of the impact of physician-scientists on translational research. Dr Barry Marshall swallowed a steaming culture of Helicobacter pylori which eventually resulted in antibiotics curing peptic ulcer disease. However, the process of training these individuals is as effortless as training fish to ride bicycles. Our journeys into the laboratory have been equally as challenging as our first encounters at the bedside. Laboratory research brings with it the need to adapt to new ways of thinking and interacting with colleagues, as well as recurrent encounters with failure. To aide fellow travelers (and perhaps relieve some of the burden of working with similar neophytes), we present a rough guide for clinicians entering the research laboratory.
1. Understanding the Road Ahead
Although the allure of a famous research institute over a sparse on-call room is strong, it is essential to look before you leap. Labs vary drastically in their ability to tolerate train clinicians and new students. Consider the following questions:
- Have there been previous clinicians in the group?
- Are there postdoctoral scientists with the relevant expertise to help guide you?
- Do you fit well within the culture of the lab?
A famous research unit might not be the one to nurture your first foray into the lab. If you have minimal bench experience, joining a group that is both capable of and enthusiastic in training clinician-scientists is non-negotiable. Meet with your supervisor and the laboratory beforehand, and if you have any doubts as to your training then clear this up before starting.
2. Walk Before You Can Run
Learning new skills takes a strong dose of humility and courage, but fortunately medicine has taught you to work with your hands, make decisions under pressure and to persevere under trying circumstances. These skills are integral to becoming a physician-scientist.
- Take it slow when learning routine lab skills and do not be ashamed by the process of starting again at novice level. You will make mistakes, repeatedly — this really is okay! For instance, Pasteur pipettes give “wildly” inaccurate volumes…and downstream results.
- Start small with your experiments: running a handful of samples (or even a single sample) correctly is better than trying to do it all at once and making a mess of the experiment.
Grand research ambitions and confidence can be scuppered by the first pipetting mistake at the bench or set of negative results
3. Build Good Relationships with Your Labmates
Your supervisor won’t be the go-to person for most problems in the lab, so successful lab work becomes a team sport where you’ll need help getting started for everything from troubleshooting experiments to unraveling a tangled yarn of statistics.
- Respect postdocs as you would seasoned senior registrars or junior consultants.
- Ask the stupid questions! It can mean the difference between weeks of failed experiments or acquiring useful data. I discovered this the hard way — six weeks of “sub-optimal” DNA sequencing because I didn’t add EDTA correctly to my PCR products for ethanol precipitation. A five minute conversation with a colleague fixed this, and my sequencing (MB).
Treat your basic science colleagues well, and hopefully you will receive the help you need, and in time pay it forward.
4. Always Take Notes
When someone is demonstrating something to you in the lab, you should take clear notes to refer to later while working at the bench. This is an important distinction from medical practice where you are often expected to memorize the important information you need in practice
5. Problem-Solve and Learn the Methods Using Available Online Resources
Troubleshooting experiments don’t generate the kind of data you can flaunt, but they are necessary to make progress in the long term. It is your responsibility to approach problems in the lab with a combination of study and practical experimentation. Many excellent resources exist to educate yourself on reagents, protocols and experimental methods:
- Reddit/molecularbiology — ask a stupid question, get a clever answer.
- Bitesizebio — already proving pretty useful, isn’t it?
- Researchgate — an online forum where you can post questions and crowd-source answers, often from experienced scientists. Be warned: answers may be “succinct” if the questions are vague.
6. Label Your Tubes Really, Really Well
Nothing is more frustrating than going over your own samples and struggling to distinguish between different tubes of colorless liquid. Ditto for plates of samples. Also, date everything. This isn’t too different from keeping good clinical notes.
7. Adjust to the Pace of Laboratory Research
Both authors experienced bouts of shapeless anxiety that they were just not doing enough at the start of their research projects. Research is not only about running experiments. Time spent reading, writing, planning, analyzing and forming networks can still be time well spent.
8. Get to Know Your P-values
If you have some down time waiting for samples to arrive for example, it’s always worthwhile learning basic statistics. If you’re training was like ours then you’ll also be light on these skills. A few very useful online resources for short stats courses include:
- Coursera — many excellent courses combining video tutorials and practicals.
- Lynda — like Coursera, but subscription based with an emphasis on tertiary education.
- Youtube — not a joke, we promise.
9. Get Used to Failure and Rejection
Data is hardly ever perfect, and especially not the first time you run an experiment. The consequences for failure in medicine involve lawsuits, disability and death as a worst-case-scenario. Entering the laboratory requires a shift in mindset as failure is an essential element of the scientific process.
- Learn how to troubleshoot and improve your experimental design.
- Keep an emotional distance from your data and from any rejections of papers or grants. Don’t take these mistakes or rejections personally like you might have done at the bedside.
In time, you will learn how to run the experiments better, and see the gaps in your writing.
If you have the desire to add complex biological research to the enormously challenging career of clinical medicine, then you probably don’t need us to motivate you further. We hope that our advice will smooth your transition and make the process more enjoyable. Make the most of the change of pace! Starting in the laboratory can feel bewildering but remember that others are experiencing the same thing with you, and many of our clinician-scientist forebears have made discoveries that have shaped both medicine and humanity itself.
This article was authored by Michael Boswell and Ashley Jacobs. Ashley is a clinician-scientist studying the humoral immune response to Mycobacterium tuberculosis in the context of vaccine development. He is based at the University of Cape Town, South Africa.